How many times have you, after a particularly hard day, reached for some chocolate or ice cream? It’s common for many people, but for those trying to lose weight, it can be detrimental to their long term success, and most weight-loss programs never even address it.

They focus on choosing healthier foods and exercising more, but they never answer a key question: how can people who have eaten to cope with emotions change their eating habits, when they haven’t learned other ways of coping with emotions?

Researchers at Temple’s Center for Obesity Research are trying to figure out the answer as part of a new, NIH-funded weight loss study. The new treatment incorporates skills that directly address the emotional eating, and essentially adds those skills to a state-of-the art behavioral weight loss treatment.

“The problem that we’re trying to address is that the success rates for long-term weight loss are not as good as we would like them to be,” said Edie Goldbacher, a postdoctoral fellow at CORE. “Emotional eating may be one reason why people don’t do as well in behavioral weight loss groups, because these groups don’t address emotional eating or any of its contributing factors.”

The study has already had one wave of participants come through, and many participants have seen some success in the short term, but have also learned the skills to help them achieve long term success.

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Janet Williams, part of that first cohort, said she lost about 17 pounds over 22 weeks, and still uses some of the techniques she learned in the study to help maintain her weight, which has not fluctuated.

“The program doesn’t just help you identify when you eat,” said Williams. “It helps you recognize triggers that make you eat, to help you break that cycle of reaching for food every time you feel bored, or frustrated, or sad.”

Williams said that the program teaches various techniques to help break that cycle, such as the “conveyor belt,” in which participants, when overcome with a specific emotion, can recognize it and take a step back, before reaching for chips or cookies, and put those feelings on their mental “conveyor belt” and watch them go away.

“I still use the skills I learned in the study,” she said. “I’ve learned to say, ‘I will not allow this emotional episode to control my eating habits.'”

PORTLAND, Ore. — A new study finds that a self-guided, 12-week program helps binge eaters stop binging for up to a year and the program can also save money for those who participate. Recurrent binge eating is the most common eating disorder in the country, affecting more than three percent of the population, or nine million people, yet few treatment options are available.

But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program — compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.

“It is unusual to find a program like this that works well, and also saves the patient money. It’s a win-win for everyone,” said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. “This type of program is something that all health care systems should consider implementing.”

“People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the health care system millions of extra dollars,” said the study’s principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. “Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that’s great news for patients and their providers.”

Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.

This randomized controlled trial, conducted in 2004–2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.

Click image to read reviews: Book helps achieve results in this research study

Half of the participants were enrolled in the intervention and asked to read the book “Overcoming Binge Eating” by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of 12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20–25 minutes. The average cost of the intervention was $167 per patient.

All participants were mailed fliers detailing the health plan’s offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.

By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.

Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.

The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.

“While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them,” said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.

Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.

In a recent study published in the Journal of the American Dietetic Association, Dr. Robinson-O’Brien and colleagues examined the link between vegetarianism and a number of health indicators to help us better understand the benefits and risks of vegetarianism in young adults. The authors discussed how vegetarianism is associated with a number of benefits such as increased consumption of fruits and vegetable and lower caloric and energy intake. However, if not done properly, vegetarian diets may also lead to deficiencies in a number of nutrients. In addition, some studies have suggested that teens who have image problems and eating disorders may be more likely to turn to vegetarianism in order to lose weight.

In order to more carefully examine the possible risks and benefits of vegetarian diets in teenagers, the authors collected information from 2,516 teenagers (15 to 18) and young adults (19-23) regarding their eating habits, vegetarian status, weight, dietary quality, physical activity, binge eating practices, healthy and unhealthy weight control behaviors, and substance use.

The authors found that the rate of vegetarianism were relatively low. Only 4% of the teens and young adults stated that they were currently vegetarians, and 11% stated that they used to be vegetarians. Vegetarianism was associated with a number of benefits including:

– a lower body mass index;

– lower rates of obesity;

– higher consumption of fruits and vegetables and;

– lower consumption of calories from fat.

However, in the younger cohort, both current and former vegetarians were more likely to engage in more extreme unhealthy weight loss measures and binge eating. Specifically, 20% of current vegetarians and 21% of former vegetarians reported engaging in unhealthy weight loss behaviors, while only 10% of the never vegetarians reported unhealthy weight loss behaviors. Likewise, 21% of current, and 16% of the former vegetarians reported binge eating, while only 4% of the never vegetarians reported engaging in this behavior. Therefore, teen vegetarians were 2 times more likely to engage in unhealthy weight loss behaviors and up to 4 times more likely to engage in binge eating.

In the older group, 27% of former vegetarians reported using unhealthy weight loss measures, which compared to 16% of current vegetarians and 15% of never vegetarians. In addition, 18% of current vegetarians and 10% of former vegetarians engaged in binge eating, compared to only 5% of never vegetarians. Therefore, young adult vegetarians and former vegetarians were more likely to engage in binge eating than never vegetarians, but only the former vegetarians (not the current) were more likely to engage in unhealthy weight control measures.

The authors conclude that although there are some clear benefits of vegetarian diets, in some teenagers and young adults vegetarianism may actually be masking eating problems.

Thus an important issue for parents encountering a teen who wants to become a vegetarian is “why.” It seems less likely (although possible) that vegetarianism is masking an eating disorder in a politically active teen who decides to become vegetarian for well presented philosophical issues related to healthy diets and/or animal rights. However, it would be more concerning if a non-politically active teen with a history of unhealthy eating habits and self-image struggles suddenly decides to become a vegetarian as a form of weight control. Now, this is not necessarily bad, since one could argue that going on a vegetarian diet is a healthy weight loss alternative – one that may actually prevent these kids from engaging in even more unhealthy eating behaviors. However, the danger is that poor vegetarian diets may further compromise the child’s health, especially among adolescents already experiencing nutrient deficiencies due to unhealthy eating habits. Thus the answer may not be to keep your child from starting a vegetarian diet, but instead to make sure that such a diet is carefully monitored, so that the child does not experience further nutrient deficiencies.

Finally, please note that the authors never actually assessed for eating disorders. They assessed unhealthy eating and weigh loss behaviors, which are usually associated with underlying eating disorders. Therefore, contrary to some news reports about this study, this study does not show that vegetarian teens are more likely to have eating disorders than non-vegetarian teens. Instead the data show that vegetarian teens are more likely to engage in unhealthy behaviors that are often associated with eating disorders.

About Peter

Peter Brown BHMS (Hons) MPsychClin MAPS

I’m a Clinical Psychologist and have a private practice and consultancy in Brisbane Australia. I have 24 years experience in child, adult and family clinical psychology. I have a wonderful wife and three kids.

I like researching issues of the brain & mind, reading and seeking out new books and resources for myself and my clients. I thought that others might be interested in some of what I have found also, hence this blog…